Marilynn Moehle, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2000167157 Issued in MO

Practice address

126 Missouri Ave
Glwach Attn MCXP-CCS-CR
Fort Leonard Wood, MO 65473-8952

Phone

(573) 596-0417

Fax

(573) 596-0524

NPI assigned

Oct 21, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962492926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "GLWACH ATTN MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "GLWACH ATTN MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEHLE",
        "first_name": "MARILYNN",
        "name_prefix": "Ms.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2000167157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Angela Metivier, DPT
• Carl S. Metzger, BSN, RN
• Gary F. Micka, MSW, LCSW
• Valeria Midgette, FNP-C
• Caroline Mikaloff
• Arturo H Montellano, MD
• David Montijo
• Desiree Lenee Moore, D.M.D.
• Laurie Anne Moore, P.A.
• Mary Sara Moore, PSYCH NP

• Pediatric Nurse Practitioner in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.